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Material and Method: Thirty-three hemodialysis patients were randomized into two treatment groups, valsartan 80 to 320 mg/day (n = 18) or non-renin-angiotensin-aldosterone-system blocking antihypertensive agents (control, n = 15), treated for 12 weeks. Insulin resistance determined by homeostasis model assessment (HOMA-IR), fasting plasma glucose (FPG), fasting plasma insulin, and blood pressure monitoring were measured during the study.
Results: At baseline, metabolic profiles did not significantly differ between the treatment and the control groups. After 12 weeks of treatment, the valsartan group significantly improved HOMA-IR from 2.6±0.9 to 2.3±0.7 (p = 0.041) and significantly decreased FPG from 90.1±15.1 to 84.8±13.2 mg/dL (p = 0.008). In contrast, the control group was not associated with any significant changes in HOMA-IR, FPG, and fasting insulin levels. At the end of 12-week treatment, HOMA-IR, FPG, and fasting insulin levels were not significantly different between the two groups.
Conclusion: These results indicate that the antihypertensive action of valsartan improves glucose metabolism by improving the peripheral insulin sensitivity in subjects with long-term dialysis.
Keywords: Insulin resistance, Glucose metabolism, Hemodialysis, Angiotensin II Receptor Blockers